Cauda equina syndrome from intradiscal electrothermal therapy

Abstract

Intradiscal electrothermal therapy (IDET) is a new procedure for the treatment of chronic, nonspecific low back pain attributed to degenerative disc disease. The targeted patients have no clinical or radiologic evidence of significant disc herniation or nerve root compression. The procedure involves placing a thermal catheter (SpineCath, Oratec Interventions, Inc., Menlo Park, CA) within an intervertebral disc via a 17-gauge introducer needle and heating the tip to 90 °C over 13 minutes and maintaining that temperature for 4 minutes. This thermal therapy is postulated to alleviate discogenic pain by shrinking collagen and denervating nerve endings in the disc annulus.1 Despite its use at various centers around the country, there are few published clinical studies that assess the efficacy of this procedure.1 It is important that IDET be publicized together with a cautionary note that, as with similar procedures, it is subject to complications. We report a patient who developed a cauda equina syndrome during IDET. A 56-year-old woman developed urinary retention, bowel incontinence, loss of sensation, and weakness in the left leg during an IDET procedure. She had been experiencing chronic low back pain for …